one prior authorization a year for neurodegenerative disease drugs

The text as introduced · 255 words

90R3268 DNC-D

By: Jones of Dallas
H.B. No. 642

A BILL TO BE ENTITLED

AN ACT

relating to prior authorization for prescription drug benefits

related to the treatment of neurodegenerative diseases.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. The heading to Subchapter N, Chapter 1369,

Insurance Code, is amended to read as follows:

SUBCHAPTER N. COVERAGE OF PRESCRIPTION DRUGS FOR AUTOIMMUNE AND

NEURODEGENERATIVE DISEASES AND CERTAIN BLOOD DISORDERS

SECTION 2. Section 1369.654, Insurance Code, is amended by

amending Subsection (a) and adding Subsection (c) to read as

follows:

(a) A health benefit plan issuer that provides prescription

drug benefits may not require an enrollee to receive more than one

prior authorization annually of the prescription drug benefit for a

prescription drug prescribed to treat an autoimmune disease, a

neurodegenerative disease, hemophilia, or Von Willebrand disease.

(c) Notwithstanding Subsection (a), a health benefit plan

issuer may require an enrollee who is prescribed a new prescription

drug to treat a neurodegenerative disease to obtain a prior

authorization for the prescription drug.

SECTION 3. The change in law made by this Act applies only

to a health benefit plan that is delivered, issued for delivery, or

renewed on or after January 1, 2028. A health benefit plan

delivered, issued for delivery, or renewed before January 1, 2028,

is governed by the law as it existed immediately before the

effective date of this Act, and that law is continued in effect for

that purpose.

SECTION 4. This Act takes effect September 1, 2027.